Optic nerve glioma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Symptoms of optic nerve glioma include proptosis, unilaterl or bilateral visual impairment, nystagmus, squinting, obstructive hydrocephalus and diencephalic syndrome.

History and Symptoms

History

Most frequently optic pathway glioma patients present in the first decade with a median age of 8.8 years. They present with slowly progressive visual loss which is followed later by proptosis. Acute visual loss due to hemorrhage into the tumor is rare.

Common Symptoms

Decreased vision (63%) is usually evident and can be documented with visual field examination if the child is old enough. Eventually mass effects will also occur, with proptosis and even intracranial sequelae including symptoms of raised intracranial pressure, focal neurological deficits and hydrocephalus from distortion of the midbrain. Involvement of the hypothalamus may result in polyuria or polydipsia.[1]

The symptoms of optic pathway gliomas usually develop over a period of months to years and usually depend upon the location of the tumor.

  • Proptosis- It is the presenting symptom.
  • Impaired vision-In patients with chiasmal lesions, it is the presenting symptom.
  • Obstructive hydrocephalus may also be noted as presenting symptom.
  • Other less frequent symptoms are:
    • Unilateral or bilateral visual impairment that starts as the loss of peripheral vision and eventually leads to blindness.
    • Involuntary eye ball movement
    • Squinting

Hypothalamic gliomas may present with symptoms of the diencephalic syndrome, which include:

    • Daytime sleeping
    • Decreased memory and brain function
    • Delayed growth
    • Loss of appetite and body fat
  • Precocious puberty- Due to involvement of hypothalamic-pituitary-gonadal axis precocious puberty may occur in 39 % of children with chiasmal optic nerve gliomas and NF-1.[2] In 10 to 20 percent of patients with optic pathway gliomas endocrinopathies due to hypothalamic extension are present.


References

  1. Optic nerve glioma. Radiopedia(2015) http://radiopaedia.org/articles/optic-nerve-glioma Accessed on October 5 2015
  2. Habiby R, Silverman B, Listernick R, Charrow J (1995). "Precocious puberty in children with neurofibromatosis type 1". J Pediatr. 126 (3): 364–7. PMID 7869193.

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